Advance Beneficiary Notice of Noncoverage
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Advance Beneficiary Notice of Noncoverage

The Centers for Medicare and Medicaid Services (CMS) has implemented use of the revised Advance Beneficiary Notice of Noncoverage (ABN) (CMS-R-131). This form replaces the following existing forms:

ABN-G (Form No. CMS-R-131G) - Advance Beneficiary Notice (General)

NEMB (Form No. CMS-20007) - Notice of Exclusion from Medicare Benefits

This revised ABN form is for providers, physicians, practitioners, and suppliers for all situations where Medicare payment is expected to be denied.  Both the form and notice instructions have been posted on the Beneficiary Notice Initiative web page at . Or, click here to download the new ABN.

Some key features of the new form are that it:

  • Has a new official title, the "Advance Beneficiary Notice of Noncoverage (ABN)", in order to more clearly convey the purpose of the notice;
  • May also be used for voluntary notifications, in place of the Notice of Exclusion from Medicare Benefits (NEMB);
  • Has a mandatory field for cost estimates of the items/services at issue; and
  • Includes a new beneficiary option, under which an individual may choose to receive an item/service, and pay for it out-of-pocket, rather than have a claim submitted to Medicare.

CMS is allowing a six-month transition period from the date of implementation for use of the revised form and instructions.  All providers and suppliers must begin using the new ABN (CMS-R-131) no later than September 1, 2008.

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